Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk.

Autor: Scheuer CM; Department of Gynaecology and Obstetrics, Nordsjællands Hospital Hillerød, Hillerød, Denmark. cathrine.munk.scheuer.01@regionh.dk., Jensen DM; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., McIntyre HD; Mater Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia., Ringholm L; Department of Endocrinology and Metabolism, Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark., Mathiesen ER; Department of Endocrinology and Metabolism, Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Nielsen CPK; Department of Gynaecology and Obstetrics, Nordsjællands Hospital Hillerød, Hillerød, Denmark., Nolsöe RLM; Department of Endocrinology and Nephrology, Nordsjællands Hospital Hillerød, Hillerød, Denmark., Milbak J; Department of Gynaecology and Obstetrics, Nordsjællands Hospital Hillerød, Hillerød, Denmark., Hillig T; Department of Clinical Biochemistry, Nordsjællands Hospital Hillerød, Hillerød, Denmark., Damm P; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark., Overgaard M; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark., Clausen TD; Department of Gynaecology and Obstetrics, Nordsjællands Hospital Hillerød, Hillerød, Denmark.; Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Acta diabetologica [Acta Diabetol] 2023 Dec; Vol. 60 (12), pp. 1663-1673. Date of Electronic Publication: 2023 Jul 18.
DOI: 10.1007/s00592-023-02148-2
Abstrakt: Aims: To estimate the prevalence of gestational diabetes mellitus (GDM) in a Danish cohort comparing the current Danish versus the WHO2013 diagnostic criteria, and to evaluate adverse pregnancy outcomes among currently untreated women in the gap between the diagnostic thresholds.
Methods: Diagnostic testing was performed by a 75 g oral glucose tolerance test (OGTT) at 24-28 weeks' gestation in a cohort of pregnant women. GDM diagnosis was based on the current Danish criterion (2-h glucose ≥ 9.0 mmol/L, GDM DK ) and on the WHO2013 criteria (fasting ≥ 5.1, 1 h ≥ 10.0 or 2 h glucose ≥ 8.5 mmol/L, GDM WHO2013 ). Currently untreated women fulfilling the WHO2013 but not the Danish diagnostic criteria were defined as New-GDM-women (GDM WHO2013 -positive and GDM DK -negative). Adverse outcomes risks were calculated using logistic regression.
Results: OGTT was completed by 465 women at a median of 25.7 weeks' gestation. GDM DK prevalence was 2.2% (N = 10) and GDM WHO2013 21.5% (N = 100). New-GDM was present in 19.4% (N = 90), of whom 90.0% had elevated fasting glucose. Pregnancies complicated by New-GDM had higher frequencies of pregnancy-induced hypertension (13.3% vs 4.1%, p = 0.002), large-for-gestational-age infants (22.2% vs 9.9%, p = 0.004), neonatal hypoglycaemia (8.9% vs 1.9%, p = 0.004) and neonatal intensive care unit admission (16.7% vs 5.8%, p = 0.002) compared to pregnancies without GDM.
Conclusions: GDM prevalence increased tenfold when applying WHO2013 criteria in a Danish population, mainly driven by higher fasting glucose levels. Untreated GDM in the gap between the current Danish and the WHO2013 diagnostic criteria resulted in higher risks of adverse pregnancy outcomes.
(© 2023. The Author(s).)
Databáze: MEDLINE
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